Estrogen Contraceptive

Question 1

CONS of Estrogen

Answer 1

-High doses (>50mg/day) increases risk of VTE
-Increase risk of stroke in pts with Migraines with aura
-Increase BP & thus risk for cardiovascular disease
-Increase triglyceride levels
-Mild inhibition of bilirubin excretion (causing jaundice), cholestasis
Increased risk of gallbladder disease and liver cancer
-Decrease milk production

Question 2

Ethinyl Estradiol

Answer 2

• Most commonly used estrogen component

- Dose Ranges from 10-50 mcg (rarely need > 35mcg)

Question 3

Mestranol

Answer 3

• 50% less potent than ethinyl estradiol
• Gets covered to ethinyl estradiol in the body
• Comes in 50mcg strength only (equals 35mcg ethinyl estradiol)
• Found in Necon 1/50 and Norinyl 1+50

Question 4

Estradiol valerate

Answer 4

• Converted into naturally occurring estrogen (Estradiol)
• Only available in multiphase product in combination with progestin dienogest (Natazia)
• Doses come in 1mg, 2mg, 3mg

Question 5

Symptoms of “TOO MUCH” Estrogen

Answer 5

• Nausea
• Breast tenderness
• Headache
• Bloating
• Increased BP
• Melasma (grey-brown patches on face)

Question 6

Symptoms of “TOO LITTLE” Estrogen

Answer 6

-Spotting/breakthrough bleeding early/mid cycle